The American Health Care Act, unveiled on Monday, specifies that its proposed tax credits could not be used to buy insurance that covers abortions.
However, New York regulations, as recently adjusted by the Cuomo administration, say that most policies sold in New York must cover abortions. In fact, state-regulated health plans are obliged to pay for the procedure without applying a copayment, coinsurance, or deductible.
The GOP bill would replace the income-based tax credits available under the Affordable Care Act with age-based tax credits, ranging from $2,000 a year for people under 30 to $4,000 for people over 60. Eligibility for the credits would phase out for individuals with incomes above $75,000.
The legislation says credits may be used to buy only insurance that “does not include coverage for abortions,” with exceptions for abortions after rape or incest or that are necessary to save the life of the mother.
The bill would allow people to buy separate coverage for abortions “so long as no credit is allowed under this section with respect to the premiums for such coverage or plan.”
The New York regulations have exceptions, too. They don’t apply to large, self-insured employers, or to plans offered by religious employers. However, people using the tax credits would be buying insurance as individuals, not through an employer.
The state has also carved out exceptions for Fidelis Care, a Catholic-sponsored health plan that does not cover abortions. Fidelis Care is a major participant in Medicaid managed care and the biggest-selling private insurer available on the New York State of Health, the state’s Obamacare exchange.
The plan’s website says it does not cover abortion, sterilization, or artificial contraception, but adds: “As a member of Fidelis Care, you can secure such services through free access to the Medicaid program or through State Department of Health-contracted entities.”
If AHCA passes as written, it would put pressure on the state Department of Financial Services to weaken the abortion mandate – or render the tax credits difficult, if not impossible, for New Yorkers to claim.